Cervical Pap Smear Cytology at Kamuzu Central Hospital in Malawi: A Quality Assurance Study

Abstract 53Background:Cervical cancer remains the most common cancer in women of the developing world, largely as a result of a lack of screening. The gold standard screening test for cervical cancer, the Pap smear, has been effective in reducing cervical cancer incidence and mortality by identifying precancerous and cancerous lesions; however, little is known about quality assurance practices for gynecologic cytopathology in resource-limited settings. The goal of this study was to document baseline clinical and laboratory characteristics in the hope of improving the efficacy of cervical cancer screening and informing future quality improvement initiatives.Methods:A retrospective study of cervical cytology at Kamuzu Central Hospital, Malawi, from January 1, 2013, to April 30, 2016, was conducted.Results:Of 2,809 Pap smears processed, 2,396 (85.3%) samples were diagnostic, with 92.3% of nondiagnostic smears (381 of 413) deemed unsatisfactory because of improper collection techniques. The 18-month patient f...